The ASCO Post

KEYNOTE-177: New Analysis Confirms Benefit of Pembrolizumab vs Chemotherapy in Microsatellite Instability–High Advanced Colorectal Cancer

In an updated analysis of the pivotal phase III KEYNOTE-177 trial in microsatellite instability–high metastatic colorectal cancer, the benefit of first-line pembrolizumab continued beyond disease progression on the subsequent line of treatment, despite a high crossover to immunotherapy for patients with disease progression on first-line chemotherapy. The data were reported at the 2021 Gastrointestinal Cancers Symposium by Kai‑Keen Shiu, MD, of University College Hospital, NHS Foundation Trust, London.

Endoscopic Nasopharyngectomy vs IMRT for Previously Treated, Resectable, Locally Recurrent Nasopharyngeal Carcinoma

In a Chinese phase III trial reported in The Lancet Oncology, Liu et al found that endoscopic nasopharyngectomy was associated with improved overall survival vs intensity-modulated radiotherapy (IMRT) in patients with resectable locally recurrent nasopharyngeal carcinoma who had received prior radiotherapy.

LuPSMA Leads to Improved PSA Response, Fewer Severe Adverse Events Than Cabazitaxel in Patients With Metastatic Prostate Cancer

In the Australian phase II TheraP trial reported in The Lancet, Michael S. Hofman, FRACP, MBBS, and colleagues found that Lutetium-177–labeled PSMA-617 (LuPSMA) treatment was associated with a higher prostate-specific antigen (PSA) response rate and fewer severe adverse events vs cabazitaxel in patients with metastatic castration-resistant prostate cancer.

Adjuvant Therapy in HER2-Positive, Hormone Receptor–Positive Breast Cancer

KEYNOTE-427: First-Line Pembrolizumab in Advanced Non–Clear Cell Renal Cell Carcinoma

As reported in the Journal of Clinical Oncology by McDermott et al, findings in a cohort of the phase II KEYNOTE-427 study showed that pembrolizumab monotherapy produced durable responses as first-line treatment for advanced non–clear cell renal cell carcinoma.

New Report Reviews Methods for Reducing Waste, Improving Efficiency With Expensive Injectable Medications

Every year, significant amounts of drugs left over and unused from single-dose vials are discarded, but because of the way drugs are priced and paid for in the United States, the cost of the discarded amount cannot be recouped, according to a new congressionally mandated report from the National Academies of Sciences, Engineering, and Medicine. As many of these drugs are among the most expensive drugs on the market, including those for treating cancer, macular degeneration, and rheumatoid arthritis, the report highlighted several opportunities to reduce inefficiencies that could lead to a reduction in discarded drugs.

Trends in Germline Genetic Testing in Women Diagnosed With Breast or Ovarian Cancer

In a study of germline genetic testing in women diagnosed with breast or ovarian cancer reported in the Journal of Clinical Oncology, Allison W. Kurian, MD, MSc, and colleagues found that undertesting persists in patients with ovarian cancer, and that most pathogenic variants are found in 20 breast cancer– or ovarian cancer–associated genes, with an increase in testing for additional genes being associated with increased identification of variants of uncertain significance.

Addition of Adjuvant Pertuzumab to Chemotherapy Plus Trastuzumab in Early HER2-Positive Breast Cancer: 6-Year Follow-up of the APHINITY Trial

As reported in the Journal of Clinical Oncology by Martine Piccart, MD, PhD, and colleagues, the preplanned second interim analysis of overall survival in the phase III APHINITY trial showed no significant benefit of the addition of adjuvant pertuzumab to chemotherapy plus trastuzumab after a median follow-up of 6 years in patients with early HER2-positive breast cancer. The invasive disease–free survival benefit observed with pertuzumab at the previously reported primary analysis persisted after long-term follow-up.

Elacestrant for Heavily Pretreated Patients With ER-Positive, HER2-Negative Metastatic Breast Cancer

In a phase I trial reported in the Journal of Clinical Oncology, Aditya Bardia, MD, MPH, and colleagues identified activity of the oral selective estrogen receptor (ER) degrader elacestrant in postmenopausal women with heavily pretreated ER-positive, HER2-negative breast cancer, including those with the ER alpha gene (ESR1) mutation.

Can Weight Loss During Treatment and Follow-up Affect Breast Cancer Outcomes?

Research published by Martel et al in JNCCN—Journal of the National Comprehensive Cancer Network examined body mass index data for patients with HER2-positive early breast cancer—and found a 5% weight loss in patients over 2 years was associated with worse outcomes. Weight gain over the same time period did not affect survival rates.